This is an excerpt of a paper I wrote on child obesity for a public health course last quarter. It basically spells out and references what we all know: that there isn't the political will to regulate food industry advertising to kids. As long as this state of affairs persists, we rely on parents turning off the TV, buying healthful foods and preparing them. -- Barbara Correa, Head of a Woman
Economic efforts to reduce caloric intake
The acknowledgement that obesity is happening on a broad scale has ushered in an era of local efforts to change behavior, despite massive spending to prevent such initiatives by the food and beverage industries. In New York City, Mayor Bloomberg’s ban on super-sized sodas attempts to control portion size. Tax measures in two California cities with high levels of child obesity — Richmond, in the San Francisco Bay Area, and El Monte, in Los Angeles County — followed suit by placing soda tax measures on local ballots this November (both were sharply defeated amid big spending by beverage makers).
Such measures are fueled by longitudinal studies that show a strong correlation between added-sugar intake and increased body mass index.
An analysis of food prices and health outcomes in the Coronary Artery Risk Development in Young Adults study found that increases in soda prices were associated with lower calorie intake, lower body weight and reduced insulin resistance.
The National Health and Nutrition Examination Survey 1999-2004 found that about half the added sugar Americans consumer per day comes from soda and fruit drinks.
Soda and fruit juice drinking has increased in the past four decades as milk consumption has declined. Among children aged 2-19, milk consumption fell from 15 ounces per day in 1977-78 to under 10 ounces per day in 2003-06 (Smith et al., 5).
In the same period, fruit juice consumption rose from about 3 ounces a day to 5 ounces and non-diet soda drinking increased from 5 ounces a day to ten ounces a day in 1999-2002. Soda consumption then dropped to 10 ounces a day by 2003-06.
The 2010 U.S. Department of Agriculture analysis using demand elasticities to estimate consumer changes found that a 20 percent price increase on sweetened drinks such as soda and sweetened fruit juice could reduce weight by 4.5 pounds a year for children. However, the effectiveness of such a policy would depend on how much of the price increase would be reflected in consumer prices. If manufacturers were to absorb a price increase instead of passing it on to the consumer, the effect would be limited, the study argues. In other words, consumers need to be able to see the higher price and feel the pain of having to pay for it in order for the policy to impact purchasing decisions.
School- and community-based lifestyle interventions.
Many school- and community-based policies and government programs have been introduced in the last 15 years to curb the increase in obesity as a way to prevent T2D in children. Among people with prediabetes, a 33-to-68 percent reduction in diabetes onset had been observed with a weight loss of between five and ten percent
. Initiatives to motivate healthier eating range from calorie labeling on restaurant menus, nutrition labeling on packaged foods, education and social marketing efforts, such as the 5 a Day for Better Health program launched by the National Cancer Institute in the early 1990s.
The Healthy, Hunger-Free Kids Act of 2010 is national legislation that aims to improve nutritional content of food managed by federal programs such as the National School Lunch Program, administered by the U.S. Department of Agriculture. The law requires that common sense actions be implemented at school with the goal being to improve eating and drinking habits. Actions include providing free potable water where meals are served, serving food that meets USDA nutrition standards, limiting what kinds of food and drinks can be sold in vending machines at school and offering grants to schools or organizations involved in local farm-to-school programs.
However, there is evidence that lunch programs at schools may part of the problem. A Department of Agriculture-funded study of over 13,000 elementary school children found that children participating in the national school lunch program had a significantly higher correlation with obesity by the third grade.
The correlation could be explained by relationships between other variables, such as socioeconomic status and ethnicity (the study controlled for those co-variates and others). But the study also found frequent noncompliance with federal nutritional guidelines for school lunches in terms of lunches failing to meet fat content limits. Also, schools are offering high sugar content a la carte items such as sodas, ice-cream sandwiches and cookies alongside lunch program items.
The findings of such studies reflect the difficulties schools and other institutions face in creating successful obesity outcomes in an environment where entrenched special interests have made the rules. Clinical guidelines, educational programs and loosely-enforced nutritional standards in schools are all examples of an approach that relies on individuals acting strategically to make smart choices. What is required for real change instead is a food environment that contains default choices that would reduce caloric intake of sugary and fatty foods and drinks without consumers even being aware they are making a choice.
A recent article from an American Heart Association journal, Circulation, argues that the food industry has strategically created a food environment in which default choices consumers make are hazardous for their health and lead directly to obesity. “Although clinical guidelines, educational programs, and social marketing campaigns are important, they do not address the environmental causes of the obesity epidemic and rely on individuals to prevail over a most challenging environment” (Novak & Brownell, 2348). “Educating children about the risks of consuming sugary drinks and entreating them to consume healthier beverages like low-fat milk is certainly important. However, children leave the classroom or the doctor’s office only to confront a world where sugary drinks are cheaper and more ubiquitous than milk and where beverage marketing confronts them in movies, on the Internet, and even in schools.’’
Classroom lessons that emphasize reduced consumption of high-fact, high-sugar foods and increased fruit and vegetable intake have proven to be no match for relentless marketing and advertising of unhealthful foods to kids. At the same time, federal school lunch programs have failed to comply with both the letter and intent of federal dietary rules, in some cases becoming part of the problem instead of part of the solution.
Governments in Europe and elsewhere have taken some actions against food marketing. In the U.S., the only restrictions to date are self-regulatory standards that food companies established in 2007 through the Children’s Food and Beverage Advertising Initiative (Novak & Brownell, 2349). But the companies have effectively circumvented self-policing efforts by strategically vague definitions and through social media marketing via Twitter and Facebook, which is not transparent.
More recently, U.S. Congressional committees have attempted to engage various departments, including the Federal Drug Administration, Federal Trade Commission and USDA to develop tougher regulation aimed at compelling food companies to comply. However, up to 25% of food marketing is estimated to come from companies who are not members of the Children’s Food and Beverage Advertising Initiative trade group.
So far, despite some progress, self-regulation of the food and beverage industries on marketing to children and other policy areas has failed to improve school meal nutrition. Short of a serious threat of government regulation, that is unlikely to change, and a more active government role has so far proved politically unsaleable, the article concludes.
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